April 1st, 2010 by Richard Cooper, M.D. in Better Health Network, Health Policy, News, Opinion, Research
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Readers interested in the relationships between poverty and healthcare will want to read several new postings on the Web.
One is an article about my Rhoades Lecture at the Wayne County Medical Society in Detroit, “Poverty and Healthcare in America.” It is posted on the World Socialist Web Site.
Second is by James Marks, MD, MPH, Vice President of the Robert Wood Johnson Foundation, entitled “The Poor Feel Poorly.” It is posted on the Huffington Post site.
Third is “Health and Healthcare in America’s Poorest City,” a tragic and dramatic portrayal of America’s failures to its own in Detroit, also on the World Socialist Web Site.
Finally, here is a link to a collection of papers on social inequalities in health by the McArthur Network on SES and Health, published by the New York Academy of Medicine under the title, “Biology of Disadvantage.”
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*
March 31st, 2010 by KevinMD in Better Health Network, Health Policy, Opinion, Primary Care Wednesdays
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Medicare’s sustainable growth rate, or SGR, has been the bane of doctors for years now. To encapsulate, this is the reason for Medicare’s annual threat to cut doctors’ fees by 20% or more, only to be staved off at the last minute.
Emergency physician Shadowfax has a nice take on it, explaining why it has devastated primary care:
Primary care has many fixed expenses in addition to those we bear: they pay rent, nurses and techs and secretaries, healthcare costs for their employees, equipment, scheduling software, etc etc. The fixed costs portion of a typical office practice can be much higher, consuming 60-80% of gross revenue. Worse, many of these “fixed costs” for primary care are not truly fixed, but increase annually consistent with inflation.
I wrote several years ago that primary care is the “cheap DVD” of the medical profession — a loss leader to bring people in the door for more lucrative services. Shadowfax agrees, arguing that it’s unlikely there will be any independent primary care practices in the near future:
I predict that, if nothing else changes in the overall model of physician reimbursement, within a decade there will be almost no independent primary care left in existence — they will all have been subsumed into hospital-owned or group practices to serve as “loss leaders,” existing solely to drive referrals to profit centers like surgical services and imaging facilities.
Bingo.
*This blog post was originally published at KevinMD.com*
March 25th, 2010 by Jon LaPook, M.D. in Better Health Network, Expert Interviews, Health Policy, News, Video
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With the passage of healthcare reform, an estimated thirty two million new patients will try to find primary care doctors. That’s not going to be so easy because we already face a shortage of primary care doctors and about 13,000 more will be needed to take care of those newly eligible for insurance.
According to the American Medical Association, there are about 312,000 primary care doctors practicing in the United States. That includes family medicine, general practice (GP), internal medicine, and pediatrics. (In addition, there are 43,000 ob-gyn’s who also may serve as primary care doctors.) The estimate that another 13,000 will be needed comes from a study done by the Robert Graham Center for Policy Studies in Family Medicine and Primary Care in partnership with the Agency for Healthcare Research and Quality.
Sixty five million Americans already live in areas that don’t have enough primary care doctors. And relief is not on the way anytime soon. It takes 5 to 8 years for a first year medical student to be trained as a primary care doctor. And the trend for budding doctors over the past decade has been away from primary care and towards more lucrative specialties. Read more »
March 22nd, 2010 by Debra Gordon in Better Health Network, Health Policy, Opinion
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My alarm clock is set to “radio” and my radio is set to the local NPR station. Now, I’m not one of those people who leaps out of bed when the alarm goes off. Instead, I lie in bed slowly waking up to about 15 or 20 minutes of the morning news.
This morning however, the news just made me want to pull the covers over my head and never get out of bed. That’s because the focus was healthcare reform, and the amount of misinformation — and, yes, I have to say it: stupidity — out there about what the current proposals will or won’t do is making me literally sick to my stomach. Read more »
*This blog post was originally published at A Medical Writer's Musings on Medicine and Health Care*
March 5th, 2010 by BobDoherty in Announcements, Better Health Network, Health Policy
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Last week, I was honored to learn that the ACP Advocate blog was selected by voters in a national competition as the Best Health Policy/Ethics blog of 2009. Yesterday, ACP issued a news release announcing the award, in which I am quoted as saying that the blog “seeks to inform and entertain readers and to elicit thoughtful commentary from across the political spectrum, not just from ACP members but from others with an interest in health policy.”
Awards and recognition are nice, but what I enjoy most is making readers aware of interesting ideas, studies, and commentary that otherwise might not have come to your attention. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
